Biomedical Engineering Reference
In-Depth Information
pathologies, fractures related to osteoporosis, back pain, serious injuries and
different sorts of bone diseases and disabilities are among the most common
causes of hundreds of millions of people worldwide suffering severe long-
term pain and becoming physically handicapped or crippled.
It has been reported that over 100 million europeans suffer chronic
musculoskeletal pain, while in the USA musculoskeletal problems affect
over 40 million people aged 45 years or older and are projected to affect
more than 60 million persons, or 22% of the population, by
the year 2030.
While mortality from these conditions is low, they have a major effect on
disability, medical costs and patient quality of life (Murray and lopez, 1996;
White and Harth, 1999).
The two most commonly reported causes of pain worldwide are back pain
and arthritis. These two conditions represent a third of all reported causes.
low-back pain is the most common problem, affecting approximately 4-33%
of the population. Although back pain affects almost everyone at some
point in life, it seems to be more prevalent in men and in younger people.
Arthritis, a pathology that involves damage to and inflammation of the joints,
is the most frequent cause of pain in women and in older people. In fact, it
has been estimated that osteoarthritis affects nearly 10% of men and 18%
of women aged over 60 years, while rheumatoid arthritis, which is a more
severe disease, affects 0.3-1% of the general population and is more prevalent
among women and in developed countries (elliott
et al.
, 1999; Woolf and
Pfleger, 2003). Moreover, it has been estimated that approximately 40% of
arthritic adults suffer from osteoarthritis of the knee, 80% of people with
osteoarthritis have limitation of movement and 25% cannot perform their
major daily activities (Brooks, 2002).
osteoporosis and, particularly, fractures caused by this illness are another
of the most common problems affecting contemporary society. osteoporosis
has been defined as a condition in which BMD (bone mass density) is 2.5
standard deviations or more below the mean seen in young healthy subjects
(WHO, 1994). Osteoporotic fractures primarily result from low BMD.
However, microstructural changes in bone, especially of trabecular bone,
also contribute significantly by increasing trabecular brittleness
.
This fragility
is translated in an increase of vertebra, wrist and hip fractures (Kanis and
Melton, 1994; Bonjour
et al
., 1996).
The prevalence of osteoporosis in the USA only is estimated to increase
from ten million to more than 14 million people by 2020. This is a significant
increase in population with a high risk of falls and fractures (national
osteoporosis Foundation, 2002). Indeed, fractures related to osteoporosis
have almost doubled in number in the last decade and it is foreseen that 40%
of all women over 50 years will suffer from an osteoporotic fracture (Bone
and Joint Decade's Musculoskeletal Portal, 2001). Although osteoporosis
is less prevalent in men than in women, it is estimated that 30% of all hip
